Wednesday, January 18, 2012

Oh the Pain

When I graduated high school, I started working for my grandfather as his psuedo-secretary at his prosthetics business (prosthetics are artificial arms and legs).  I say "psuedo-secretary" because my aunt was his "real" secretary and I came in a few days a week to pay bills and type letters and file papers.  Unless, of course, it was raining.  In which case my grandfather would call and tell me not to come in because it was too dangerous to drive.

I digress.

When I graduated college and moved back home from Montana, I started working for my father at his prosthetics business.  I was the "real" secretary over there and had to deal with patients, bills, files, phone calls, and my dad.  The only thing more frustrating than dealing with my dad (love you, Pops!), was dealing with insurance companies.  They never wanted to pay for anything.  You always had to fight to get the proper equipment for the patient.  And they never, ever, returned a phone call, so you had to keep calling them until you actually spoke to a human.  I was pretty glad when I started my own business - making cakes, not prosthetics - because that meant I didn't have to deal with insurance companies anymore.

That is no longer the case.

Did you know that private insurance companies do not cover hearing aids or any routine hearing tests related to hearing aids?  They will pay to help you quit smoking and even for a wig if you lose your hair during chemo treatments, but they will not pay if you have a hearing loss and need hearing aids in order to be able to function in society.

I know this because it says it under "Exclusions" in my insurance policy handbook.  Right after it says "We will pay for everything BUT..."

Do you know how much hearing aids cost?  Probably not, because, like me, you're not to the age at which you might possibly require hearing aids. 

That age, by the way, is around 85.

Hearing aids are not cheap.  They are, in fact, quite expensive.  Have you bought a new mattress lately?  Hearing aids are the price of a Tempurpedic.

And that's just the little mechanical part that goes behind the ear.  There's also the part that goes inside the ear.  That's the ear mould.  In little kids, that needs to be replaced regularly as they grow and their ear canal gets bigger, causing the hearing aid to whistle.  Every set of ear moulds is a couple hundred bucks.

Did I mention hearing aids aren't covered by insurance?

Let's not forget to mention that every time you head on over to UCLA to get the ear moulds fitted, they have to do hearing tests to make sure that the hearing aids are working properly and that your hearing has stayed the same as when they initially tested and programmed the hearing aids.

Yeah, those tests aren't covered either.

The only way to get hearing aids, and moulds, and tests paid for by someone other than yourself, is to apply for Medi-Cal... and, in our case, California Children Services (CCS).  If you qualify (and by qualify, I mean they deem you poor enough), they will provide you with an authorization that is good for any and all services for exactly one year from the time in which you have been approved.

Ours expired just before Christmas.

Holidays are not the time of year in which to need something from an insurance company, let alone a state run program.  No one is at their desk that time of year.  And if they are, they sure aren't answering their phone.  I will say that our case workers at CCS are quite helpful and have gone the extra mile for us.  However, the same cannot be said for the people at Medi-Cal.  Because when I called my Medi-Cal case worker (oh yes, you must have a case worker for each branch of services), I left 5 messages and not one was returned.

It took me five weeks to get someone to send me one document.  Countless phone calls over many days to finally have one person change one item in the computer (which took less than ten minutes).  Endless hours of frustration, only to know that I have to do it all again next year.

At the holidays.

But I did finally receive the authorization that says we can take our little munchkin to UCLA as often as necessary during the year of 2012. 

I made my husband take me out to dinner to celebrate.

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